{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:05:05Z","timestamp":1792663505777,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Isolated perianal fistulizing Crohn\u2019s disease (IPFCD) is an uncommon presentation of Crohn\u2019s disease with an uncertain natural history. We aimed to characterize contemporary diagnostic strategies, management approaches, and long-term outcomes, including progression to luminal Crohn\u2019s disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective multicenter cohort study across 25 centers within the ECCO-CONFER network. Adult patients with IPFCD and no evidence of luminal Crohn\u2019s disease at baseline were included. The primary outcome was progression to luminal Crohn\u2019s disease. Secondary outcomes included clinical and radiological fistula response and patterns of medical and surgical management. Time-to-event analyses were performed using Kaplan\u2013Meier methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 121 patients were included with a median follow-up of 76\u2009months (IQR 46-118). Diagnostic pathways were heterogeneous, with most patients undergoing colonoscopy (91.7%) and pelvic magnetic resonance imaging (63.6%), alongside variable use of additional modalities. Management was intensive, with 76.9% receiving biologic therapies and 85.1% undergoing combined medical\u2013surgical treatment. Complete clinical remission was achieved in 57% of patients, while radiological healing was observed in 46.4%. During follow-up, 42 (34.7%) patients developed luminal Crohn\u2019s disease. Median progression-free survival was 145.6\u2009months, with a median time to luminal diagnosis of 110\u2009months (IQR 40-152). No consistent predictors of progression were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Approximately one-third of patients with IPFCD developed luminal Crohn\u2019s disease over long-term follow-up, typically after several years. However, many patients remain free of intestinal involvement, reflecting a heterogenous disease course and highlighting the need for standardized evaluation and improved risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjag130","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:16:17Z","timestamp":1786706177000},"source":"Crossref","is-referenced-by-count":2,"title":["Isolated perianal fistulizing Crohn\u2019s disease in contemporary clinical practice: a multicenter ECCO-CONFER cohort study"],"prefix":"10.1093","volume":"20","author":[{"given":"Kumarini","family":"Basnayake","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust , Cambridge,","place":["United 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Gastroenterology, Washington University School of Medicine in Saint Louis , St Louis, MO,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6437-5062","authenticated-orcid":false,"given":"Sami","family":"Samaan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Washington University School of Medicine in Saint Louis , St Louis, MO,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia La","family":"Mantia","sequence":"additional","affiliation":[{"name":"Digestive and Interventional Endoscopy Unit, ASST Grande Ospedale Metropolitano Niguarda , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9554-4785","authenticated-orcid":false,"given":"Olga Maria","family":"Nardone","sequence":"additional","affiliation":[{"name":"Department of Public Health, University Federico II of Naples , Naples,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin R","family":"Howard","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Hepatology and Nutrition, University of Minnesota , Minneapolis, MN,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco L\u00f3pez","family":"Romero-Salazar","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital Universitario 12 de Octubre , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Ram\u00edrez Alc\u00e1zar","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital Universitario 12 de Octubre , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Centritto","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Eastern Piedmont , Novara,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3898-7093","authenticated-orcid":false,"given":"Bram","family":"Verstockt","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospitals Leuven , Leuven,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5490-4350","authenticated-orcid":false,"given":"Catherine","family":"Reenaers","sequence":"additional","affiliation":[{"name":"University Hospital (CHU) & GIGA Institute, Liege University , Liege,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8424-202X","authenticated-orcid":false,"given":"Luke","family":"Hanna","sequence":"additional","affiliation":[{"name":"IBD Unit, St Mark\u2019s Hospital, London North West University Healthcare NHS Trust , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5677-2534","authenticated-orcid":false,"given":"Simone","family":"Saibeni","sequence":"additional","affiliation":[{"name":"IBD Unit, Gastroenterology Unit, Rho Hospital, ASST Rhodense , Rho,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafal","family":"Filip","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology with IBD Unit, St. Jadwiga Queen Hospital No. 2 , Rzesz\u00f3w,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Hale","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust , Sheffield,","place":["United 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Turin,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0126-2929","authenticated-orcid":false,"given":"Jeroen","family":"Geldof","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Ghent University Hospital , Ghent,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Gawron-Kiszka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Prof. K. Gibi\u0144ski University Clinical Centre of Medical University of Silesia in Katowice , Katowice,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0076-8549","authenticated-orcid":false,"given":"Cristina","family":"Bezzio","sequence":"additional","affiliation":[{"name":"IBD Center, IRCCS Humanitas Research Hospital , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Gojdi\u010dov\u00e1","sequence":"additional","affiliation":[{"name":"Gastroenterology Center, Poliklinika Bezru\u010dova , Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3488-2593","authenticated-orcid":false,"given":"Edyta","family":"Zag\u00f3rowicz","sequence":"additional","affiliation":[{"name":"Department of Oncological Gastroenterology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology , 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